On April 14, 1982, President Reagan established the Presidential Commission Against Drunk Driving (PCDD). This commission established 39 recommendations to curb what was perceived to be a drunken driving epidemic. Taken together, the 39 recommendations were intended to be comprehensive approach with a goal of reducing the number of alcohol-related deaths on the nation’s highways. Recommendation number eight concerned the Minimum Legal Purchasing Age, and said that all states should raise their drinking age to 21, lest they lose a certain percentage of federal highway dollars. Though the target of the Commission’s recommendations was intended to be drunk driving across the adult population, the disproportionate amount of attention paid to establishing 21 as the national minimum drinking age shifted the nation’s focus to young people’s drinking. Exclusive interest in raising the drinking age marginalized the effect of the remaining 38 recommendations, among them suggestions to implement youth education programs, establish a massive public information campaign, and to increase penalties for convicted drunken drivers.

Two years later, on July 17, 1984, after extensive lobbying from groups such as MADD, President Reagan signed the National Minimum Drinking Age Act, effectively creating a national minimum drinking age of 21.

Mothers Against Drunk Driving (MADD; then called Mothers Against Drunk Drivers) was founded by Candy Lightner in response to the 1980 death of her young daughter upon being struck by a repeat offense drunk driver. The organization and Lightner’s testimony during Senate subcommittee hearings on the bill played an indispensable role in generating support from Congress, President Reagan and the general public for a standardized, nationwide 21 year-old drinking age.

Do any exceptions to Legal Age 21 exist under the National Minimum Drinking Age Act?

Currently, the Federal Law provides for the following exceptions under the original legislation:1

…the possession of alcohol for an established religious purpose; when accompanied by a parent, spouse or legal guardian age 21 or older; for medical purposes when prescribed or administered by a licensed physician, pharmacist, dentist, nurse, hospital or medical institution; in private clubs or establishments; or to the sale, handling, transport, or service in dispensing of any alcoholic beverage pursuant to lawful employment of a person under the age of twenty-one years by a duly licensed manufacturer, wholesaler, or retailer of alcoholic beverages.

In effect, this provision means that states that legislate one or more exceptions to the 21 year-old drinking age are not at risk of losing federal highway funding. This results in a lack of nationwide consistency in the laws governing alcohol use for people under age 21; for example, in many states, consumption of alcohol is not prohibited outright. As of 2006, 21 states have exceptions to the law for the consumption of alcohol by those under 21 and 28 states have exceptions that pertain to the furnishing of alcohol to those under 21.2 To view the laws in your state, consult the Alcohol Policy Information System website: http://www.alcoholpolicy.niaaa.nih.gov/

Because laws governing alcohol use are usually culturally derived, there is substantial international variation in minimum legal drinking and purchase ages. Generally, a state’s drinking or purchase age—purchase age is more commonly legislated that drinking age—corresponds to the legal age of majority or the point at which an individual assumes adult roles in society.3 Among those countries that set a legal age, 18 is the most common, although in many cases the legal drinking age is ignored or unenforced. Along with Mongolia, Indonesia, Palau and several states in India and Egypt, the United States is an outlier with a minimum purchase age of 21.4

How do other countries compare to the United States in incidence of alcohol-related problems?

In terms of alcohol impaired driving and related fatalities, a recent NHTSA study that compared DUI laws in the United States to those in comparable nations, such as the European Union States, Canada, Australia, New Zealand, Japan, and Brazil, found that the United States had the highest proportion of traffic fatalities that were alcohol related among the 12 countries reporting data. The same study found that the United States has the highest legal BAC limit for impaired driving—.10 at the time of publication (2000)—and relatively lax enforcement as compared to nations like Australia, New Zealand, Sweden, and Spain where mandatory random breath testing and sobriety checkpoints were reported to be frequent and prevalent. The legal drinking age of all countries in the report was 18, with Japan and Canada being the only exceptions. Japan sets 20 as its legal limit, while the legal drinking age in Canada is 19 in all provinces except for Alberta, Quebec, and Manitoba, where people can drink legally at age 18.5

Because the United States is among an extremely small majority with a drinking age of 21, drinking by 18-20 year-old adults does not fall under as intense scrutiny in other parts of the world as it does in America. Drinking, especially that which is excessive or risky in nature, among younger adolescents is, however, a concern shared by parents, public health officials, and governments in many foreign countries. Recent research published by the World Health Organization found that while 15 and 16 year-old teens in many European states, where the drinking age is 18 or younger (and often unenforced), have more drinking occasions per month, they have fewer dangerous, intoxication occasions than their American counterparts. For example, in southern European nations ratios of all drinking occasions to intoxication occasions were quite low—roughly one in ten—while in the United States, almost half of all drinking occasions resulted in intoxication.6

Outlining the arguments…

What are the arguments for the 21 year-old drinking age?

It saves lives by preventing alcohol-related traffic fatalities for 18-20 year olds and the rest of the population

Since the developing adolescent brain is affected differently by alcohol than the adult brain, the 21 year-old drinking age protects adolescents and young adults from the its potentially negative consequences

The earlier one starts to drink, the more likely he or she will experience alcohol dependence and related problems later in life.

Any benefits of the 21 year-old drinking age have come to be more than offset by unintended and largely negative consequences.

The 21 year-old drinking age is an abridgement of the age of majority.

The 21 year-old drinking age marginalizes the role of parents in the process of teaching and encouraging responsible decisions about alcohol use.

Under the 21 year-old drinking age, fewer young people are drinking, but those who do choose to are drinking more. This alarming rise in the rates of binge drinking on campuses and in communities around the nation has caused a major, national public health problem.

The 21 year-old drinking age breeds disrespect for law and ethical compromises.

What are the short- and long-term term effects of alcohol consumption?

The immediate effects of alcohol include: depression of the central nervous system (i.e., heart and respiratory rates); decrease in motor skill control; decrease of recall and retrieval memory; decrease in inhibition; decrease in memory encoding; and increase in perceived sociability.7 Alcohol acts as a sedative on the brain and depresses neural firing within the central nervous system, an effect that is masked by a decrease in inhibition, which causes the individual’s outward affect to appear more lively than normal. In large quantities, alcohol can depress the central nervous system to the point where vital systems shut down, leading to a loss of consciousness, or, more seriously, death. More often heavy drinking leads to periods of blackout in which the drinker may be awake but unable to recall the occasion at a later date. Alcohol’s long-term effects are largely dependent upon an individual’s consumption behavior. Habitual excessive drinking can result in liver disease (cirrhosis), kidney damage, malnutrition, pancreatitis, gastritis, and a host of other unhealthy consequences.8 In addition to the unhealthy side effects of heavy alcohol consumption, neurological research also suggests those patterns of excessive drinking lead to decreases in memory recall and a decline in cognitive abilities over time.9 However, for more moderate alcohol use, research commissioned by the National Institute of Alcoholism and Alcohol Abuse (NIAAA) suggests that a serving of alcohol a day significantly reduces the risk of coronary heart disease.10 Thus, the effect of alcohol consumption in the long-term is highly dependent upon the individual’s consumption behavior. Alcohol is a potent drug that in immoderate use can have dangerous, life-long consequences. To suggest, therefore, that alcohol is harmless is misleading; yet, the preponderance of drinkers, those who drinking moderately and responsible, show minimal negative effects from alcohol.

Binge drinking is, in the words of one alcohol scholar, "the consumption of large-enough amounts of alcohol in short-enough periods of time to put the drinker and others at risk."11 Historically, a binge was depicted as a weekend-long episode of heavy drinking that left the drinker unable to perform their usual obligations. More recent interpretations of binge drinking connote night-long episodes of severe intoxication rendering the drinker not only inebriated, but in peril of alcohol poisoning.12 Thus, attempts to quantify binge drinking (how much over how long) by a single threshold has left the field of alcohol scholars divided over what does and does not constitute binge drinking. The most widely used (and most often criticized) quantification of binge drinking is the 5/4 standard employed by Henry Wechsler of the Harvard School of Public Health. It states that a binge is the consumption of five or more drinks on an occasion for males and four or more drinks on an occasion for females.13 That may not correspond to the levels of drinking the public typically imagines when they think of binge drinking, or to legal levels of intoxication when measured by other researchers, but it is a definition that for many reasons has gained traction in the public sphere. And as a result of this public salience it is the one most favored by researchers. Internationally, there are many thresholds for labeling binge drinking, none of which are as low as the 5/4 standard. Binge drinking has no single definition that satisfies everyone, but the quotation above best represents the consensus view of binge drinking.

Is the adolescent brain is affected differently by alcohol than the adult brain?

In both the short-term and the long-term, alcohol influences the adolescent brain in ways different from the adult brain. Adolescence, broadly defined as the second decade of life, neurologically extends until the age of 25.14

In a state of alcohol impairment (short-term effects), the adolescent brain is impaired in ways similar to the adult brain but to differing degrees.15 In various animal experiments, the adolescent brain shows greater alcohol induced impairment of memory retrieval and imprinting capabilities than the adult brain.16 This is to say that the adolescent brain is worse at remembering things while drunk, and remembering things that happened while drunk. Contrastingly, the adolescent brain is less impaired in motor skill control than the adult brain.17 That is, the adolescent brain maintains a higher level of balance, reaction time, and hand eye coordination while under the same level of impairment as an adult brain. Since it is unethical to supply alcohol to those below the drinking age in a laboratory setting researchers are forced to use rats for experimental trials. Any application of these findings to humans is necessarily somewhat speculative.

Concerning long-term effects, experimental rat lab evidence indicate that repeated exposure to alcohol during adolescence leads to long-lasting deficits in cognitive abilities, including learning and memory.18 Results from human studies are less clear. Brain scans and measurements of alcohol affected areas of the brain in young adolescents with alcohol abuse disorders show lower rates of brain activity during memory tasks and less developed brain structures than in non-drinking peers.19 Although the results are troubling, they are consistent with findings from older, non-adolescent subjects.20 Thus, the cognitive deficits attributed to alcohol use in adolescents are indicative not of alcohol’s unique effect during adolescents, but of the consequences of heavy alcohol use more generally.

Has Legal Age 21 been effective in reducing the number of alcohol related fatalities for those aged 18 to 20?

The record is mixed. Many studies confirm that since the drinking age was standardized at 21 in 1984, the overall number of alcohol related fatalities for those aged 18-20 has decreased. However, this pattern of decline began in the early 1970s, years before passage of the National Minimum Drinking Age Act. Though organizations like MADD claim the 21 year-old drinking age has saved over 21,000 lives since the mid-1980s,21 its is impossible to assert a cause and effect relationship between the change in the law and the decline in alcohol-related traffic fatalities; many other factors, such as safer vehicles and more stringent drunk driving laws have played an undeniably important role (see below). Several scholars have also presented the important argument that while deaths on the road may have declined sharply among 18-20 year-olds in the years following enactment of the 21 year-old drinking age, the slowest rate of decline and greatest number of annual fatalities is seen each year in the 21-24 age group.22 In 2002, for example, twice as many 21 year-olds died in alcohol-related auto accidents as 18 year-olds.23 Such a staggering statistic speaks volumes: a policy that claims to be saving thousands of each year may simply be re-distributing deaths over the life cycle to the point at which it becomes legal to drink alcohol—age 21.

Furthermore, for all alcohol related fatalities not associated with automobiles, raising the drinking age to 21 has had no discernible effect on fatalities associated with alcohol. Alcohol-related suicides, accidents, drownings, murders, and alcohol poisoning rates have shown no decline associated with the drinking age.24 Death or injury from alcohol overdose has become a great concern to parents, teachers, high school and college administrators since the drinking age was raised to 21.

What alternative explanations might help to account for the reduction of alcohol-related driving fatalities?

During the 1980s and 1990s, legislative changes, increased law enforcement, tougher prosecution and punishment, highly visible advocacy, and public education were all components of the "war on drunk driving." Other legislative changes, such as mandatory seat belt laws, lower BAC limits, and stricter rules on automobile safety standards can also be credited. The decline in alcohol-related fatalities seen in the United States over the past two and a half decades is attributable to a combination of factors, including but not limited to safer vehicles, increased public awareness of the danger of drunk driving, use of designated drivers—a term that did not exist in the before the drinking age was raised—sobriety checkpoints, zero-tolerance laws for young drivers, and altogether more stringent enforcement of alcohol-impaired driving laws have led to the reduction seen in rates of drunk driving and related deaths. In fact, many of these improvements can be traced to the 39 recommendations presented by the Presidential Commission Against Drunk Driving in 1982. According to an analysis by NHTSA, safety belts and air bags have had a vastly greater effect in preventing fatalities than the 21 year-old drinking age; for example, in 2002 and 2003 alone, more lives on the road were saved by the use of safety belts and airbags than there were in the entire history of the 21 year-old drinking age.25

Interventions over the past twenty years have succeeded not only in reducing the incidence of impaired driving and the crashes and fatalities that can result from it, but also in changing the norms related to driving after drinking. Drunken driving is no longer generally accepted in society, giving rise to designated drivers and fewer drunk drivers on today’s roads.

The age of majority is the age at which an individual acquires the legal rights and responsibilities which define him or her as an adult. Examples of these include the right to vote and hold office, the right to enlist in the armed forces, and the right to enter legally binding contracts, the right to marry, adopt children and engage in consensual sexual acts. In the United States, the age of majority is 18. In most other countries, the age of majority coincides with the legal drinking or purchasing age.26

Will a lower drinking age foster greater rates of alcohol abuse later in life?

It is unlikely that a lower drinking age would increase rates of alcohol abuse. Although a significant body of literature suggests that an early onset of alcohol use is correlative with alcohol abuse later in life,27 the same literature also indicates no significant difference in rates of alcohol abuse between those who start drinking at 18, 19, 20 or 21.28 Those young people who begin to drink in early adolescence are more likely to end up with alcohol use problems later in life. It would still be just as illegal for young teens to drink, but under the new law there would be incentives for not using alcohol until one is 18 and punishments for those choose to break the law.

Taking a Fresh Approach…

If the drinking age is lowered, what provisions could be made to keep alcohol from being readily available to those younger than 18?

In order to act as functional social policy, any attempt to lower the drinking age would need to be accompanied by provisions intended to keep alcohol away from young people under 18. Instead of lowering the drinking age to 18 and automatically allowing 18 year-olds all the privileges enjoyed now by those 21 and older, a better approach may be to regulate alcohol use by those 18-20 years of age through a graduated licensing system. This could consist of a period following an individual’s eighteenth birthday in which he or she could drink only under the supervision of a parent or guardian. That individual could then pay a fee reflective of the program’s implementation cost and enroll in a state-administered alcohol education course. Upon successful completion of the course requirements, an alcohol license would be issued, allowing that individual to consume alcohol within the confines of the law.

In order to prevent minors’ ease of access to alcohol, anyone who chooses to enroll in the course must have successfully completed secondary education. Furthermore, anyone with an alcohol license who is caught driving while intoxicated, furnishing alcohol to minors, or in violation of any other provision of the law would have his or her license and all drinking privileges revoked until reaching age 21.

Since there is no comprehensive course that fits the needs of an education program of this magnitude, the recommended alcohol education course would be an amalgam of effective programs presently available, designed by alcohol experts and educators. Learning to drive a vehicle and learning to drink responsibly are remarkably similar processes; accordingly, we believe that an alcohol education course modeled on the length and format of driver’s education has much to recommend it. We envision a course comprised of both inside- and outside-the-classroom sessions that culminate in a final examination whose successful completion earns the student a license to purchase and consume alcohol. Course content would include a detailed review of alcohol laws, the history of alcohol use in America, information regarding the short- and long-term effects of alcohol on the body and brain, how America’s beliefs about alcohol use compare to those of the rest of the world, and explanations of what is responsible drinking versus irresponsible drinking. Ultimately, the primary goal of the course is to reinforce responsible drinking and encourage young adults to make informed decisions about alcohol use. The available literature suggests that the best way to do this is through social norms education, a practice that informs the individual of actual rates of alcohol use among his or her peers—numbers which are often much lower than expected. This has been shown to have the effect of reducing consumption and harmful drinking patterns.29 An alcohol education course would also provide a forum for various views in the community, hopefully including local MADD chapters, law enforcement, and public health officials. These groups would play a role both in the development of the course modules and by involving students in outside-the-classroom sessions, such as experiencing court hearings in drunken driving cases or attending a meeting of a local alcoholics’ support group.

Why would a mandatory alcohol education course have the effect of decreasing irresponsible drinking and other problematic, alcohol-related behaviors?

If developed and implemented correctly, a mandatory alcohol education course would present new drinkers with a successful model for responsible and moderate behavior. By avoiding the pitfalls encountered by previous alcohol education programs—especially those that stress complete abstinence, the costs incurred as a result of alcohol-related crime and accidents, or the negative and addictive qualities of alcohol—such a program could define and model responsible use. Instead of highlighting the negative consequences of consumption and stigmatizing any and all alcohol use, an effective program would provide guidelines for healthy ways to consume alcohol, discourage drinking to the point of intoxication, and clearly outline both the negative and positive social and personal effects of drinking. The program would also be accompanied by a clear presentation of drinking laws and penalties for their violation. Provided to all newly enfranchised drinkers, the course information would present a viable, socially acceptable alternative to binge and goal-oriented drinking—the two activities that lead most often to auto accidents, crime, and overdose.

Above and beyond the content of the course, the effectiveness of an alcohol education program is contingent upon treating its subjects as adults. The existence of such a course would serve as acknowledgement of the fact that those over 18 can make healthy, informed decisions when armed with the right information. For many adolescents, alcohol is a vehicle for social rebellion, its abuse a function of asserting one’s independence from infantilizing social policies. An alcohol education course would help normalize society’s treatment of alcohol and its users.

There is overwhelming evidence which shows that the vast majority of 18-20 year olds choose to ignore the law and drink anyway.30 Unfortunately, since these young adults are breaking the law, they choose to drink in clandestine locations to avoid prosecution. This promotes unsafe and irresponsible drinking and has led to the development of a dangerous subculture among today’s youth defined by drinking games, "pregaming," and large, out-of-control parties whose sole focus is drinking beyond the point of intoxication.

Should the legal drinking age be lowered to 18, the privilege to drink would be contingent upon completion of an intensive alcohol education course specifically aimed at reducing at-risk drinking and promoting responsible, safe consumption. Because young adults would no longer have to drink behind closed doors to avoid getting caught, their formative encounters with alcohol would be in supervised, controlled environments. An 18 year-old drinking age would effectively remove young adult’s drinking from secretive, and dangerous locations.

If you can’t keep alcohol from passing between college seniors to freshmen, what makes you think that there would be any greater success in stopping this transfer from 18 year-olds to younger teenagers?

A graduated licensing system has the potential to restrict the transfer of alcohol from 18 year-olds to younger teens. After a period of being permitted to drink only under parental supervision, 18 year-olds would then be allowed to enroll in an extensive alcohol education course, earning a drinking license upon successful completion. Individuals would be prevented from enrolling in the course until finishing secondary education.

Furthermore, any violation of the state’s alcohol control laws, such as furnishing to minors or driving under the influence of alcohol, would result in immediate suspension of the drinking license. Young people caught drinking before they reach age 18 and obtain a license would be delayed from enrolling in the alcohol education course for a specified period of time.

If a state were to implement an 18 year-old drinking age, how would you keep its borders from becoming "blood borders?"

Because alcohol use by 18-20 year-olds would be permitted only with an appropriate license, it would be illegal for residents between those ages of neighboring states to enter that state and purchase alcohol. The privilege to obtain such a license would be limited to that state’s residents and full-time students at its residential colleges. If necessary, an electronic scanning system could provide a sufficient technological deterrent to counterfeiting and improve ID-checking protocols in liquor outlets, grocery stores, bars, and restaurants.

If my state lowers its drinking age, it will just loose millions of dollars each year in federal highway funding. What will this proposal do to remedy that?

We acknowledge that little change can taken place on the state level so long as the federal government threatens to withhold a substantial amount of highway funding each year. Accordingly, a major part of our proposal is to recommend that Congress permit states to apply for a waiver of the federal highway-funding condition. In order to obtain such a waiver, states that hope to lower the drinking age must submit to Congress a coherent and comprehensive plan to educate and license young adults to purchase, possess and consume alcohol. A waiver would only be granted to a state with an acceptable program on the grounds that it must show a measurable decrease in the incidence of alcohol-traffic crashes and fatalities, as well as in rates of binge drinking and other factors related to harmful drinking. The appropriate data, all of which is already collected and analyzed by various governmental agencies, would be gathered over a five year period and presented to Congress at its completion. Based on those findings, a state could request extension of the waiver for another five year period.

Why do you think a change in the legal drinking age is a viable strategy for reducing harmful and dangerous drinking patterns in young people?

The combination of incentive and reward offered by the education and licensing program promises positive effects for those under and over 18 alike. Penalties for violation of alcohol control laws will encourage younger adolescents to abstain until they reach age 18; at the same time, those laws will encourage those over 18 who choose to drink to do so responsibly so as to avoid revocation of their drinking license. Perhaps most importantly, though, this proposal will re-involve parents, teachers, and other role models in the process of teaching young adults how to drink in moderation. Marginalized under the current law, these figures would again be legally permitted to introduce young adults to alcohol consumption in the home and other safe, supervised locations.

Would reducing the drinking age be a recipe for public health disaster?

Advocates of a 21 year-old drinking age claim that lowering the drinking age would lead to several public health problems. Their concerns are twofold: increased rates of alcohol abuse and decreased mental faculties amongst new drinkers.

If the present 21 year-old drinking age were actually effective in reducing underage drinking in the 18-20 year-old cohort, then lowering the drinking age to 18 could very well increase rates of alcohol abuse. The logic is that a lower drinking age would provide access to alcohol to otherwise abstinent, but, potential abusers. However, the reality of the present drinking age is that it is ineffective in keeping alcohol out of the hands of underage drinkers, specifically those who are already in college, ages 18-20. Albeit misguided, the argument concerning the risk-prone nature of young adults is an important one. If the drinking age were lowered it would give colleges and universities, and foremost parents the opportunity to promote the healthy use of alcohol and provide a safe and supervised setting for young adults to consume alcohol. In terms of controlling and forestalling risky behavior, such an environment would be a vast improvement over the basements, dorm rooms, and fraternity houses where risky drinking behavior currently takes place. Secondly, if consuming alcohol before the age of 21 does have a deleterious effect on the cognitive abilities of drinkers should there not be an entire generation of Americans that came of age from 1973-1984, even whole continents of people (Europe, most of Asia, Latin America, and Oceania), who are less intelligent, or cognitively impaired because of their early exposure to alcohol? The premise of such an argument is so outlandish, in fact, that no such study has ever been conducted.

Why lower the drinking age now when there are more pressing matters facing the country?

In the more than two decades that have passed since its implementation, the 21 year-old drinking age has created a climate in which terms like "binge" and "pregame" have come describe young peoples’ choices about alcohol; in which the law is habitually and thoughtlessly ignored by adolescents and adults alike; in which colleges and communities across the nation are plagued with out-of-control parties, property damage, and belligerent drunks; in which emergency rooms and campus health centers are faced with an alarming number of sometimes fatal cases of alcohol poisoning and overdose on weekend nights; and in which the role of parents in teaching responsible behavior around alcohol has been marginalized and the family disenfranchised. Maintaining status quo in America today is not an option.

We are faced with a law that is out of step with our cultural attitudes towards alcohol, one which encourages violation and breeds disrespect. Historically, we know that during the Vietnam War the 26 th Amendment in 1971 provided 18 year-olds the right to vote, the age at which one could be drafted to fight in the war. This constitutional recognition of 18 year-olds as consenting adults was fundamental for guaranteeing the right for 18 year-olds to drink. Again, a quarter century later, we are engaged in a war where many of the soldiers currently serving abroad are under the legal drinking age of 21. And while that historical parallel itself does not provide justification for changing the drinking age, it makes strikingly clear the poor logic behind the assumption that at the age of 18 one is too immature to consume alcohol. If the drinking age were lowered, it would signal a transformation in the relationship our society has with its young adults. Besides engendering greater respect for the law, a lower and more easily enforced drinking age would offer alternative choices for parents and college campuses around the country in shaping responsible drinking behaviors and encouraging informed decisions about alcohol use.